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Effects of Computer-based Prescribing on Pharmacist Work Patterns

Affiliations of the authors: Purdue University (MDM), Wishard Health Services (BL), Indiana University School of Medicine (WT, GJE, X-HZ, WMT), and Regenstrief Institute for Health Care (MDM, X-HZ, WMT), all in Indianapolis, Indiana.

Correspondence and reprints: Michael D. Murray, PharmD, Regenstrief Institute for Health Care, Regenstrief Health Center, Sixth Floor, 1001 West Tenth Street, Indianapolis, IN 46202; e-mail: <murray m{at}regenstrief.iupui.edu>

Abstract Objective: To measure the effect of computer-based outpatient prescription writing by internal medicine physicians on pharmacist work patterns.

Design: Work sampling at a hospital-based outpatient pharmacy. Data were collected from pharmacists wearing silent, random-signal generators before and after the implementation of computer-based prescribing.

Measurements: The type of work performed by pharmacists (activity), the reason for their work (function), and the people they contacted (contact) were measured.

Results: Total staff hours and prescriptions handled were similar before and after computer-based prescribing. Pharmacists recorded 4,687 observations before and 4,735 observations after implementation of computer-based outpatient prescription writing. After implementation, pharmacists spent 12.9 percent more time correcting prescription problems, had 3.9 percent less idle time, and spent 2.2 percent less time in discussions with others. Pharmacists also spent 34.0 percent less time filling prescriptions, 45.8 percent more time in problem-solving activities involving prescriptions, and 3.4 percent less time providing advice. Over 80 percent of pharmacist time was spent working alone both before and after computer-based outpatient prescription writing.

Conclusion: Computer-based prescribing results in major changes in the type of work done by hospital-based outpatient pharmacists and in the reason for their work and small changes in the people contacted during their work.

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